This month our #ReSNetSLT chat is led by Mélanie Gréaux, who is currently working on her PhD study in New Delhi.
Team ReSNetSLT thanks @IJLCD for generously making this paper free access until the end of August, so that we can feature it for this chat – and can recommend others to read it too.
This paper explores parental perspectives around speech and language development, delay and intervention. Interestingly, the focus is not on any parental beliefs and reported practices, but specifically on those perceived to be ‘under-served’ or ‘hard-to-reach’ in relation to Speech and Language Therapy (SLT) services.
Whilst SLTs provide services to a very diverse population in England, there is increasing and alarming evidence that significant disparities exist around SLT accessibility and engagement for certain groups. This is illustrated, for example, by trends in referral patterns for different socio-economic status or ethnic groups.
According to the Evidence-Based Practice model, understanding the perspectives of stakeholders should lead to better clinical outcomes and impact. Therefore, exploring the views of parents (and particularly those identified as ‘under-served’ or ‘hard-to-reach’) can bring to light crucial information to inform better access and engagement with SLT services by all.
The authors used semi-structured focus groups to elicit the perspectives of parents. Three groups were identified as ‘under-served’ or ‘hard-to-reach’, namely:
(1) Looked-after children.
(2) Children from a range of minority ethnic groups (including specific communities and refugees and asylum seekers), and
(3) Children whose families are from areas of low socio-economic status.
Two focus group discussions for each of these identified ‘hard-to-reach’ or ‘under-served’ parent groups were conducted. Methodological decisions and limitations are discussed and transparently reported (e.g. participant recruitment and generalisation of findings).
The findings section is structured around four main themes:
(1) Language development and the environment,
(2) Causes and signs of speech and language delay,
(3) Responses to concerns about speech, language and communication, and
(4) Improving SLT.
Interestingly, there is a wide variety of beliefs and reported practices, both within and across groups. These beliefs and reported practices include ‘facilitative’ approaches that SLTs would traditionally encourage (e.g. early and frequent language input), as well as ‘detrimental’ approaches that SLTs would usually try to influence (e.g. negative views about bilingualism).
The diversity of these beliefs and practices highlights the importance for clinicians to treat each family individually. Importantly, eliciting and engaging with the families’ beliefs should enable culturally competent practices. This, in turn, can facilitate positive changes in behaviour to benefit children’s language and communication development and overall engagement with SLT services in ‘under-served’ or ‘hard-to-reach’ groups.
We encourage clinicians to reflect on your own current practice for ‘under-served’ or ‘hard-to-reach’ clients, share your relevant CPD activities, and discuss your perceptions of the implications for future research.
Our questions for discussion:
- What do you already do (or would like to do) to facilitate SLT access and engagement for ‘under-served’ or ‘hard-to-reach’ clients? (Please indicate which specific groups you’re referring to).
- What do you think is the impact of the COVID-19 pandemic on traditionally (or newly) perceived ‘under-served’ or ‘hard-to-reach’ clients with regards to SLT access and engagement?
- “SLTs need to be competent at eliciting information from families, armed with sufficient cultural knowledge to support that discussion”. What CPD activities have you already completed (or would like to complete) to develop these skills and knowledge?
- How would you facilitate engagement with ‘hard-to-reach’ participants in research studies?